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https://www.readbyqxmd.com/read/29923322/effects-of-sodium-glucose-co-transport-2-inhibitors-in-addition-to-insulin-therapy-in-type-2-diabetes-on-cardiovascular-risk-factors-a-meta-analysis-of-randomized-controlled-trials
#1
Bingshu Wu, Hongzhi Zheng, Jianqiu Gu, Yan Guo, Yixuan Liu, Yingfang Wang, Feng Chen, Aolin Yang, Jiabei Wang, Hailong Wang, Ying Liu, Difei Wang
INTRODUCTION: In this meta-analysis, we aimed to determine the effects of SGLT-2i in addition to insulin therapy on cardiovascular risk factors in type 2 diabetic patients MATERIALS AND METHODS: RCTs were identified by searching the PubMed, Embase, and Cochrane Library databases published before September 2017. Intervention group received SGLT-2i as add-on to insulin therapy, controlled with those received placebos in addition to insulin. We assessed pooled data, including WMDs and 95% CIs, using a random-effects model RESULTS: Ten RCTs (n =5159) were eligible...
June 19, 2018: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29922347/the-cardiovascular-benefits-associated-with-the-use-of-sodium-glucose-cotransporter-2-inhibitors-real-world-data
#2
REVIEW
Gallwitz Baptist
Type 2 diabetes (T2D) is associated with numerous comorbidities that significantly reduce quality of life, increase mortality and complicate treatment decisions. In a recent cardiovascular outcomes trial, Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), the sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin was shown to reduce cardiovascular (CV) mortality and heart failure in high-risk patients with T2D with a previous CV event or with established CV disease (CVD)...
April 2018: European Endocrinology
https://www.readbyqxmd.com/read/29916741/combined-sglt1-and-sglt2-inhibitors-and-their-role-in-diabetes-care
#3
Thomas Danne, Torben Biester, Olga Kordonouri
The sodium-glucose cotransporter type 1 (SGLT1) is the primary transporter for absorption of glucose and galactose in the gastrointestinal tract. Inhibition blunts and delays postprandial glucose (PPG) excursion. Sodium-glucose cotransporter type 2 (SGLT2) is expressed in the kidney, where it reabsorbs 90% of filtered glucose. Thus, a dual SGLT1 and SGLT2 inhibition (compared with selective SGLT2 inhibition) could result in lower PPG and robust A1c reduction even in patients with reduced kidney function. Sotagliflozin is an oral potent dual inhibitor of the insulin-independent SGLT1 and SGLT2...
June 2018: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/29912999/implications-of-cardiovascular-outcomes-trials-in-type-2-diabetes-for-primary-care
#4
Jeff Unger
Patients with type 2 diabetes (T2D) are at a greater risk of cardiovascular (CV) morbidity and mortality than their counterparts without diabetes. Worsening glycemic control is associated with increasing risk of CV events and mortality, but glycemic control alone does not appear sufficient to improve CV outcomes. Furthermore, some glucose-lowering drugs have been associated with an increased risk of CV events. As a result, the US Food and Drug Administration (FDA) issued guidance in 2008 for the investigation of CV risk with new diabetes therapies...
June 2018: Journal of Family Practice
https://www.readbyqxmd.com/read/29899991/prolonged-diabetic-ketoacidosis-associated-with-canagliflozin
#5
Gordon Sloan, Tania Kakoudaki, Nishant Ranjan
We report a case of a 63-year-old man who developed diabetic ketoacidosis (DKA) associated with canagliflozin, a sodium glucose co-transporter 2 (SGLT-2) inhibitor. He presented acutely unwell with a silent myocardial infarction, diverticulitis and DKA with a minimally raised blood glucose level. Standard therapy for DKA was initiated. Despite this, ketonaemia persisted for a total of 12 days after discontinuation of canagliflozin. Glucosuria lasting for several days despite discontinuation of the medications is a recognised phenomenon...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29898853/the-design-and-rationale-for-the-dapagliflozin-effect-on-cardiovascular-events-declare-timi-58-trial
#6
Stephen D Wiviott, Itamar Raz, Marc P Bonaca, Ofri Mosenzon, Eri T Kato, Avivit Cahn, Michael G Silverman, Sameer Bansilal, Deepak L Bhatt, Lawrence A Leiter, Darren K McGuire, John Ph Wilding, Ingrid Am Gause-Nilsson, Anna Maria Langkilde, Peter A Johansson, Marc S Sabatine
BACKGROUND: Dapagliflozin is a sodium-glucose co-transporter-2 (SGLT-2) inhibitor that reduces blood glucose in patients with type 2 diabetes mellitus (T2DM) by promoting glycosuria via inhibiting urinary glucose reabsorption. In addition to improving blood glucose control, treatment with dapagliflozin results in glucose-induced osmotic diuresis, weight loss, and blood pressure lowering. Previous trials of SGLT-2 inhibitors showed reductions in cardiovascular (CV) events, including CV death and hospitalization for heart failure, and ischemic events in patients with atherosclerotic cardiovascular disease (ASCVD)...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29895557/effect-of-empagliflozin-on-liver-fat-in-patients-with-type-2-diabetes-and-nonalcoholic-fatty-liver-disease-a-randomized-controlled-trial-e-lift-trial
#7
Mohammad Shafi Kuchay, Sonal Krishan, Sunil Kumar Mishra, Khalid Jamal Farooqui, Manish Kumar Singh, Jasjeet Singh Wasir, Beena Bansal, Parjeet Kaur, Ganesh Jevalikar, Harmendeep Kaur Gill, Narendra Singh Choudhary, Ambrish Mithal
OBJECTIVE: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have been shown to reduce liver fat in rodent models. Data regarding the effect of SGLT-2 inhibitors on human liver fat are scarce. This study examined the effect of empagliflozin (an SGLT-2 inhibitor) on liver fat in patients with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) by using MRI-derived proton density fat fraction (MRI-PDFF). RESEARCH DESIGN AND METHODS: Fifty patients with type 2 diabetes and NAFLD were randomly assigned to either the empagliflozin group (standard treatment for type 2 diabetes plus empagliflozin 10 mg daily) or the control group (standard treatment without empagliflozin) for 20 weeks...
June 12, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29873444/protective-effects-of-sglt2-inhibitor-luseogliflozin-on-pancreatic-%C3%AE-cells-in-db-db-mice-the-earlier-and-longer-the-better
#8
Tomohiko Kimura, Atsushi Obata, Masashi Shimoda, Seizo Okauchi, Yukiko Kanda-Kimura, Yuka Nogami, Saeko Moriuchi, Hidenori Hirukawa, Kenji Kohara, Shuhei Nakanishi, Tomoatsu Mune, Kohei Kaku, Hideaki Kaneto
AIMS: We compared the protective effects of sodium glucose co-transporter (SGLT) 2 inhibitor luseogliflozin on pancreatic β-cells between in an early and advanced stage of diabetes and between after short- and long-term use. MATERIALS AND METHODS: Diabetic db/db mice were treated with luseogliflozin for 2 weeks in an early stage (7-9 weeks of age) and an advanced stage of diabetes (16-18 weeks) and for a longer period of time (7-18 weeks). We performed various morphological analyses of pancreatic islets and examined gene expression profiles in islets after such treatment...
June 6, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29865997/combination-of-sglt-2-inhibitors-and-glp-1-receptor-agonists-potential-benefits-in-surrogate-and-hard-endpoints
#9
Michael Doumas, Κonstantinos Imprialos, Konstantinos Stavropoulos, Andromachi Reklou, Alexandros Sachinidis, Vasilios G Athyros
BACKGROUND: The treatment of type 2 diabetes mellitus (T2DM) is complex; only few patients successfully attain glycemic targets with monotherapy, most requiring drug combination therapy. METHODS: The goal of this review was to identify in PubMed the complimentary ways of action leading to clinical benefit (in lowering HbA1c, body weight, renal, and cardiac risk factors and events) of the combination of sodium glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA)...
June 3, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29858843/the-effect-of-antidiabetic-medications-on-non-alcoholic-fatty-liver-disease-nafld
#10
Laura Iogna Prat, Emmanuel A Tsochatzis
Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome and is prevalent in more than 50% of patients with type II diabetes. At present, there is no approved therapy for NASH. Until now, the only proven effective interventions in improving biochemical and histological features of NASH, including fibrosis, are weight loss and physical activity even without weight loss. Because of the common epidemiological and pathophysiological features between NAFLD and T2DM, many antidiabetics drugs have been tested in patients with NAFLD over the years...
April 17, 2018: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29807374/-diabetes-mellitus-type-2-recent-publications-and-new-drugs
#11
Ulf Elbelt
Since 2013 several placebo-controlled cardiovascular outcomes trails on new classes of glucose-lowering agents in addition to standard care have been reported. These trails were designed to demonstrate non-inferiority to placebo with regard to cardiovascular safety for patients with type 2 diabetes mellitus at high cardiovascular risk.For the glucagon-like peptide 1 (GLP-1)-receptor agonists liraglutide and semaglutide as well as for the sodium-glucose cotransporter-2 (SGLT-2) inhibitors empagliflozin and canagliflozin statistically significant reductions of the primary composite outcome (nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death) were demonstrated...
June 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29802538/effects-of-the-sglt-2-inhibitor-empagliflozin-on-renal-tissue-oxygenation-in-non-diabetic-subjects-a-randomized-double-blind-placebo-controlled-study-protocol
#12
Marie-Eve Muller, Menno Pruijm, Olivier Bonny, Michel Burnier, Anne Zanchi
INTRODUCTION: Empagliflozin is an SGLT-2 inhibitor (SGLT-2i) which belongs to a new class of hypoglycemic drugs with the unique property of decreasing blood glucose independently from insulin, through an increase in glycosuria. In addition to decreasing cardiovascular morbidity and mortality, empagliflozin has nephroprotective properties in high cardiovascular risk patients with type 2 diabetes. Decreased hyperfiltration and shifting towards more favorable renal fuel energetics with improved renal oxygenation may explain some of these properties...
May 25, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29794497/sglt-inhibition-a-possible-adjunctive-treatment-for-type-1-diabetes
#13
Halis Kaan Akturk, Amanda Rewers, Satish K Garg
PURPOSE OF REVIEW: To identify and evaluate the recent trials of sodium-glucose cotransporter 1 and 2 (SGLT1 and SGLT2, respectively) inhibitor use in patients with type 1 diabetes (T1D). SGLT-2 inhibitors have been approved by the Food and Drug Administration (FDA) and are effectively used in the treatment of type 2 diabetes (T2D). However, many studies (phase I-III) have validated their effects beyond improving glycemic control and have shown potential adjunctive use in adult patients with T1D treated with insulin therapy alone...
May 24, 2018: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/29792136/sglt-2-inhibitors-in-diabetic-kidney-disease-what-lies-behind-their-renoprotective-properties
#14
Panagiotis I Georgianos, Maria Divani, Theodoros Eleftheriadis, Peter R Mertens, Vassilios Liakopoulos
BACKGROUND: Despite optimal management of diabetic kidney disease (DKD) with intensive glycemic control and administration of agents blocking the renin-angiotensin-aldosterone-system, the residual risk for nephropathy progression to end-stage-renal-disease (ESRD) remains high. Sodium-glucose co-transporter type 2 (SGLT-2)-inhibitors represent a newly-introduced anti-diabetic drug class with pleiotropic actions extending above their glucose-lowering efficacy. Herein, we provide an overview of preclinical and clinical-trial evidence supporting a protective effect of SGLT-2 inhibitors on DKD...
May 23, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29764222/comparative-efficacy-of-once-weekly-semaglutide-and-sglt-2-inhibitors-in-type-2-diabetic-patients-inadequately-controlled-with-metformin-monotherapy-a-systematic-literature-review-and-network-meta-analysis
#15
Rohini Sharma, Lars Wilkinson, Hrvoje Vrazic, Evan Popoff, Sandra Lopes, Steve Kanters, Eric Druyts
OBJECTIVE: Treatment intensification with additional anti-diabetic agents is recommended in type 2 diabetes (T2D) for patients inadequately controlled on metformin monotherapy. The present network meta-analysis (NMA) evaluated comparative efficacy and safety of once-weekly semaglutide and sodium-glucose co-transporter 2 inhibitors (SGLT-2is) in T2D patients inadequately controlled with metformin. METHODS: Randomized controlled trials with ≥20 weeks duration were searched in EMBASE, MEDLINE, and CENTRAL...
May 29, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29760945/liraglutide-and-dulaglutide-therapy-in-addition-to-sglt-2-inhibitor-and-metformin-treatment-in-indian-type-2-diabetics-a-real-world-retrospective-observational-study
#16
S Ghosal, B Sinha
Background: Therapy for Type 2 diabetes (T2D) has been transformed by the introduction of newer agents like Glucagon like Peptide Receptor Agonists (GLP-1RA) and Sodium-glucose linked transporter inhibitors (SGLT2i). However with co-initiation of SGLT2i and GLP-1RA in the DURATION 8 trial an improvement in HbA1c was noted but the beneficial effect was not equal to the sum of its parts. In view of this we proceeded to test the hypothesis that sequential addition of GLP-1RA therapy to metformin and SGLT-2i may be more beneficial...
2018: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29753563/critical-appraisal-of-the-2018-acc-scientific-sessions-late-breaking-trials-from-a-statistician-s-perspective
#17
REVIEW
Stuart J Pocock, Tim J Collier
The late-breaking clinical trials presentations at the American College of Cardiology Scientific Sessions in March 2018 are an important contribution to the field of cardiology. This paper presents a constructive critical appraisal of 7 key studies: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab), VEST (Vest Prevention of Early Sudden Death Trial), SECURE-PCI (Statins Evaluation in Coronary Procedures and Revascularization), TREAT (Ticagrelor in Patients with ST-Elevation Myocardial Infarction treated with Pharmacological Thrombolysis), POISE (PeriOperative ISchemic Evaluation), SMART-DATE (Safety of 6-Month Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome), and CVD-REAL 2 (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors)...
May 7, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29748368/cardiovascular-effects-of-new-oral-glucose-lowering-agents-dpp-4-and-sglt-2-inhibitors
#18
REVIEW
André J Scheen
Cardiovascular disease (CVD) is a major challenge in the management of type 2 diabetes mellitus. Glucose-lowering agents that reduce the risk of major cardiovascular events would be considered a major advance, as recently reported with liraglutide and semaglutide, 2 glucagon-like peptide-1 receptor agonists, and with empagliflozin and canagliflozin, 2 SGLT-2 (sodium-glucose cotransporter type 2) inhibitors, but not with DPP-4 (dipeptidyl peptidase-4) inhibitors. The present review is devoted to CV effects of new oral glucose-lowering agents...
May 11, 2018: Circulation Research
https://www.readbyqxmd.com/read/29732725/time-trends-and-geographical-variation-in-prescribing-of-drugs-for-diabetes-in-england-1998-2017
#19
Helen J Curtis, John M Dennis, Beverley M Shields, Alex J Walker, Seb Bacon, Andrew T Hattersley, Angus G Jones, Ben Goldacre
AIMS: UK guidelines for type II diabetes leave the choice of glucose lowering therapies after metformin largely to prescribers. They vary greatly in cost, and comparative effectiveness data is lacking. We set out to measure the variation in prescribing of these second-line non-insulin diabetes drugs. MATERIALS AND METHODS: We evaluated time trends 1998-2016, using England's publicly available prescribing datasets, and stratified by the order prescribed to patients using the Clinical Practice Research Datalink (CPRD)...
May 7, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29721589/cardiovascular-outcome-in-type-2-diabetes-and-atrial-fibrillation
#20
A Costard-Jäckle, D Tschöpe, T Meinertz
Diabetes is an independent risk factor for atrial fibrillation (AF). Frequently, it is part of the metabolic syndrome cluster, which includes obesity and hypertension that are independently associated with AF. The risk appears to be higher with longer duration of diabetes and inadequate glycemic control. Patients with diabetes and AF have a substantially increased risk of death and serious cardiovascular complications compared with those in sinus rhythm. Conversely, good metabolic control appears to be associated with maintenance of rhythm after successful therapeutic conversion to sinus rhythm by catheter ablation or electrical cardioconversion of AF...
May 2, 2018: Herz
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